Lees, Emily A. and Williams, Thomas C. and Marlow, Robin and Fitzgerald, Felicity and Jones, Christine and Lyall, Hermione and Bamford, Alasdair and Pollock, Louisa and Smith, Andrew and Lamagni, Theresa and Kent, Alison and Whittaker, Elizabeth (2024) Epidemiology and management of pediatric group A streptococcal pneumonia with parapneumonic effusion: an observational study. Pediatric Infectious Disease Journal, 43 (9). pp. 841-850. ISSN 0891-3668
AI Summary:
A study on invasive group A streptococcal infections in children reported an unseasonal increase in cases. The majority of cases occurred with viral coinfection, highlighting the need for routine vaccination coverage and progress on vaccines for other common viruses.AI Topics:
Background: During autumn/winter 2022, UK pediatricians reported an unseasonal increase in invasive group A streptococcal infections; a striking proportion presenting with pneumonia with parapneumonic effusion. Methods: Clinicians across the United Kingdom were requested to submit pseudonymized clinical data using a standardized report form for children (<16 years) admitted between September 30, 2022 and February 17, 2023, with microbiologically confirmed group A streptococcal pneumonia with parapneumonic effusion. Results: From 185 cases submitted, the median patient age was 4.4 years, and 163 (88.1%) were previously healthy. Respiratory viral coinfection was detected on admission for 101/153 (66.0%) children using extended respiratory pathogen polymerase chain reaction panel. Molecular testing was the primary method of detecting group A streptococcus on pleural fluid (86/171; 50.3% samples). Primary surgical management was undertaken in 171 (92.4%) children; 153/171 (89.4%) had pleural drain inserted (96 with fibrinolytic agent), 14/171 (8.2%) had video-assisted thoracoscopic surgery. Fever duration after admission was prolonged (median, 12 days; interquartile range, 9–16). Intravenous antibiotic courses varied in length (median, 14 days; interquartile range, 12–21), with many children receiving multiple broad-spectrum antibiotics, although evidence for additional bacterial infection was limited. Conclusions: Most cases occurred with viral coinfection, a previously well-recognized risk with influenza and varicella zoster, highlighting the need to ensure routine vaccination coverage and progress on vaccines for other common viruses (eg, respiratory syncytial virus, human metapneumovirus) and for group A streptococcus. Molecular testing is valuable to detect viral coinfection and confirm invasive group A streptococcal diagnosis, expediting the incorporation of cases into national reporting systems. Range and duration of intravenous antibiotics administered demonstrated the need for research on the optimal duration of antimicrobials and improved stewardship.
Lees, Emily A.
Author
Lees, Emily A. and Williams, Thomas C. and Marlow, Robin and Fitzgerald, Felicity and Jones, Christine and Lyall, Hermione and Bamford, Alasdair and Pollock, Louisa and Smith, Andrew and Lamagni, Theresa and Kent, Alison and Whittaker, Elizabeth (2024) Epidemiology and management of pediatric group A streptococcal pneumonia with parapneumonic effusion: an observational study. Pediatric Infectious Disease Journal, 43 (9). pp. 841-850. ISSN 0891-3668
See full publications listWilliams, Thomas C.
Author
Lees, Emily A. and Williams, Thomas C. and Marlow, Robin and Fitzgerald, Felicity and Jones, Christine and Lyall, Hermione and Bamford, Alasdair and Pollock, Louisa and Smith, Andrew and Lamagni, Theresa and Kent, Alison and Whittaker, Elizabeth (2024) Epidemiology and management of pediatric group A streptococcal pneumonia with parapneumonic effusion: an observational study. Pediatric Infectious Disease Journal, 43 (9). pp. 841-850. ISSN 0891-3668
See full publications listMarlow, Robin
Author
Lees, Emily A. and Williams, Thomas C. and Marlow, Robin and Fitzgerald, Felicity and Jones, Christine and Lyall, Hermione and Bamford, Alasdair and Pollock, Louisa and Smith, Andrew and Lamagni, Theresa and Kent, Alison and Whittaker, Elizabeth (2024) Epidemiology and management of pediatric group A streptococcal pneumonia with parapneumonic effusion: an observational study. Pediatric Infectious Disease Journal, 43 (9). pp. 841-850. ISSN 0891-3668
See full publications listFitzgerald, Felicity
Author
Lees, Emily A. and Williams, Thomas C. and Marlow, Robin and Fitzgerald, Felicity and Jones, Christine and Lyall, Hermione and Bamford, Alasdair and Pollock, Louisa and Smith, Andrew and Lamagni, Theresa and Kent, Alison and Whittaker, Elizabeth (2024) Epidemiology and management of pediatric group A streptococcal pneumonia with parapneumonic effusion: an observational study. Pediatric Infectious Disease Journal, 43 (9). pp. 841-850. ISSN 0891-3668
See full publications listJones, Christine
Author
Lees, Emily A. and Williams, Thomas C. and Marlow, Robin and Fitzgerald, Felicity and Jones, Christine and Lyall, Hermione and Bamford, Alasdair and Pollock, Louisa and Smith, Andrew and Lamagni, Theresa and Kent, Alison and Whittaker, Elizabeth (2024) Epidemiology and management of pediatric group A streptococcal pneumonia with parapneumonic effusion: an observational study. Pediatric Infectious Disease Journal, 43 (9). pp. 841-850. ISSN 0891-3668
See full publications listLyall, Hermione
Author
Lees, Emily A. and Williams, Thomas C. and Marlow, Robin and Fitzgerald, Felicity and Jones, Christine and Lyall, Hermione and Bamford, Alasdair and Pollock, Louisa and Smith, Andrew and Lamagni, Theresa and Kent, Alison and Whittaker, Elizabeth (2024) Epidemiology and management of pediatric group A streptococcal pneumonia with parapneumonic effusion: an observational study. Pediatric Infectious Disease Journal, 43 (9). pp. 841-850. ISSN 0891-3668
See full publications listBamford, Alasdair
Author
Lees, Emily A. and Williams, Thomas C. and Marlow, Robin and Fitzgerald, Felicity and Jones, Christine and Lyall, Hermione and Bamford, Alasdair and Pollock, Louisa and Smith, Andrew and Lamagni, Theresa and Kent, Alison and Whittaker, Elizabeth (2024) Epidemiology and management of pediatric group A streptococcal pneumonia with parapneumonic effusion: an observational study. Pediatric Infectious Disease Journal, 43 (9). pp. 841-850. ISSN 0891-3668
See full publications listPollock, Louisa
Author
Lees, Emily A. and Williams, Thomas C. and Marlow, Robin and Fitzgerald, Felicity and Jones, Christine and Lyall, Hermione and Bamford, Alasdair and Pollock, Louisa and Smith, Andrew and Lamagni, Theresa and Kent, Alison and Whittaker, Elizabeth (2024) Epidemiology and management of pediatric group A streptococcal pneumonia with parapneumonic effusion: an observational study. Pediatric Infectious Disease Journal, 43 (9). pp. 841-850. ISSN 0891-3668
See full publications listSmith, Andrew J.
Author
Pagnossin, Davide and Smith, Andrew and Weir, William and McDonald, Eisin and Coelho, Juliana and Ure, Roisin and Oravcová, Katarina (2025) Epidemiological and genomic characterisation of an outbreak of Streptococcus pyogenes emm5.23. Journal of Infection. ISSN 0163-4453 (In Press)
Pajak-Zajac, Malgorzata Z. and Dowdell, Adam and Potts, Hugh E. and Smith, Andrew and Diver, Declan (2025) Drain decontamination using in-situ generated ozone. Journal of Hospital Infection, 159. pp. 100-105. ISSN 0195-6701
Shaw, David and Torreblanca, Raquel Abad and Amin-Chowdhury, Zahin and Bautista, Adriana and Bennett, Desiree and Broughton, Karen and Casanova, Carlo and Choi, Eun Hwa and Claus, Heike and Corcoran, Mary and Cottrell, Simon and Cunney, Robert and Cuypers, Lize and Dalby, Tine and Davies, Heather and de Gouveia, Linda and Deghmane, Ala-Eddine and Desmet, Stefanie and Domenech, Mirian and Drew, Richard and Plessis, Mignon du and Duarte, Carolina and Fuursted, Kurt and Golden, Alyssa and Almeida, Samanta Cristine Grassi and Henares, Desiree and Henriques-Normark, Birgitta and Hilty, Markus and Hoffmann, Steen and Humphreys, Hilary and Jacobsson, Susanne and Johnson, Christopher and Jolley, Keith A. and Kawabata, Aníbal and Kozakova, Jana and Kristinsson, Karl G. and Krizova, Pavla and Kuch, Alicja and Ladhani, Shamez and Lâm, Thiên-Trí and Ayala, María Eugenia León and Lindholm, Laura and Litt, David and Maiden, Martin C. J. and Martin, Irene and Martiny, Delphine and Mattheus, Wesley and McCarthy, Noel D. and Meehan, Mary and Meiring, Susan and Mölling, Paula and Morfeldt, Eva and Morgan, Julie and Mulhall, Robert and Muñoz-Almagro, Carmen and Murdoch, David and Musilek, Martin and Novakova, Ludmila and Oftadeh, Shahin and Perez-Arguello, Amaresh and Pérez-Vázquez, Maria Dolores and Perrin, Monique and Prevost, Benoit and Roberts, Maria and Rokney, Assaf and Ron, Merav and Sanabria, Olga Marina and Scott, Kevin J. and Sempere, Julio and Siira, Lotta and de Lemos, Ana Paula Silva and Sintchenko, Vitali and Skoczyńska, Anna and Slotved, Hans-Christian and Smith, Andrew J. and Taha, Muhamed-Kheir and Toropainen, Maija and Tzanakaki, Georgina and Vainio, Anni and van der Linden, Mark P. G. and van Sorge, Nina M. and Varon, Emmanuelle and Moreno, Julio Vazquez and Vohrnova, Sandra and von Gottberg, Anne and Yuste, Jose and Brueggemann, Angela B. (2025) The importance of microbiology reference laboratories and adequate funding for infectious disease surveillance. Lancet Digital Health, 7 (4). e275-e281. ISSN 2589-7500
See full publications listLamagni, Theresa
Author
Lees, Emily A. and Williams, Thomas C. and Marlow, Robin and Fitzgerald, Felicity and Jones, Christine and Lyall, Hermione and Bamford, Alasdair and Pollock, Louisa and Smith, Andrew and Lamagni, Theresa and Kent, Alison and Whittaker, Elizabeth (2024) Epidemiology and management of pediatric group A streptococcal pneumonia with parapneumonic effusion: an observational study. Pediatric Infectious Disease Journal, 43 (9). pp. 841-850. ISSN 0891-3668
See full publications listKent, Alison
Author
Lees, Emily A. and Williams, Thomas C. and Marlow, Robin and Fitzgerald, Felicity and Jones, Christine and Lyall, Hermione and Bamford, Alasdair and Pollock, Louisa and Smith, Andrew and Lamagni, Theresa and Kent, Alison and Whittaker, Elizabeth (2024) Epidemiology and management of pediatric group A streptococcal pneumonia with parapneumonic effusion: an observational study. Pediatric Infectious Disease Journal, 43 (9). pp. 841-850. ISSN 0891-3668
See full publications listWhittaker, Elizabeth
Author
Lees, Emily A. and Williams, Thomas C. and Marlow, Robin and Fitzgerald, Felicity and Jones, Christine and Lyall, Hermione and Bamford, Alasdair and Pollock, Louisa and Smith, Andrew and Lamagni, Theresa and Kent, Alison and Whittaker, Elizabeth (2024) Epidemiology and management of pediatric group A streptococcal pneumonia with parapneumonic effusion: an observational study. Pediatric Infectious Disease Journal, 43 (9). pp. 841-850. ISSN 0891-3668
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